(Nakamura et al., 1965a,b;Crompton et al., 1966), coma vigile (Gerstenbrand, 1967), parasomnia (Jefferson, 1944), akinetic mutism (Cairns et al., 1941), and apallic syndrome (Kretschmer, 1940). Recently, Jennett and Plum (1972) We arbitrarily designed the following criteria in order to study such patients: (1) defect of verbal and behavioural communication; (2) loss of expression of intention; (3) absence, or at least reduction of emotional expression; (4) urinary and faecal incontinence; (5) complete loss of selfsupportability; (6) continuation of above conditions for more than three months, regardless of causative disease. Patients and methodsIn response to simple inquiries to 269 hospitals in 16 prefectures of western Japan on 1 June 1973, 193 potentially suitable cases were reported from 189 hospitals; we then visited each hospital and examined each patient. Based on the above criteria, 110 patients were included in our study.Although we were unable to assess the incidence of vegetative patients for all districts responding to our inquiry our survey did cover all hospitals within Yamaguchi prefecture, a population of approximately 1.5 million. We found 37 vegetative patients, an incidence of 0.0025%.We examined the behaviour, response to various stimuli, and neurological signs of the 110 patients in our sample. Analyses were also made of the results of ancillary examinations, methods of management of the patients, and effectiveness of treatment given. In order to assess the level of 876

PURPOSE. Epithelial-mesenchymal transition (EMT) in retinal pigment epithelial (RPE) cells is related to the pathogenesis of subretinal fibrosis such as that associated with macular degeneration. The role of myocardin-related transcription factor A (MRTF-A) in EMT of RPE cells and subretinal fibrosis was investigated.METHODS. The migratory activity of human RPE-1 cells in culture was evaluated using a scratch assay. The subcellular distribution of MRTF-A in RPE-1 cells, as well as the extent of subretinal fibrosis in a mouse model, were determined by immunofluorescence analysis. Expression of a-smooth muscle actin (a-SMA), collagen type I (COL1), connective tissue growth factor (CTGF), and paxillin was examined by immunoblot analysis or reverse transcription and quantitative polymerase chain reaction analysis, whereas that of pro-matrix metalloproteinase-2 (MMP-2) was assessed by gelatin zymography.RESULTS. The MRTF-A signaling inhibitor CCG-1423 suppressed RPE-1 cell migration in a concentration-dependent manner. Transforming growth factor-beta (TGF-b2) induced MRTF-A translocation from the cytoplasm to the nucleus of RPE-1 cells, and this effect was attenuated by CCG-1423. TGF-b2 up-regulated the abundance of a-SMA, paxillin, and pro-MMP-2 proteins as well as the amounts of a-SMA, COL1, and CTGF mRNAs in a manner sensitive to inhibition by CCG-1423. Finally, intravitreal injection of CCG-1423 markedly attenuated the development of subretinal fibrosis induced by photocoagulation in vivo. CONCLUSIONS.Our results implicate MRTF-A in EMT of RPE cells and in the development of subretinal fibrosis in vivo, suggesting that MRTF-A is a potential therapeutic target for retinal diseases characterized by subretinal fibrosis.

A case of metastatic small cell carcinoma to the pineal body is reported and the clinical and radiological features of this rare tumor are discussed. A 66-year-old man presented with progressive dementia, gait disturbance, vertical gaze palsy. and convergence retraction nystagmus. Computed tomographic scan revealed a 2 × 3-cm high-density mass in the pineal region, which showed strong contrast enhancement. The tumor was resected through a right occipital transtentorial approach. The pathological diagnosis of the surgical specimens was small cell carcinoma. A systemic workup for the primary lesion subsequently revealed small cell carcinoma of the lung. Although occurring rarely, metastatic tumor should be considered in the differential diagnosis of pineal tumor in elderly patients.

Materials and methodsCriteria for selection of the patients and method of survey have been described in the previous paper. We continued to keep contact with attending physicians in each hospital as to outcome of the patients once a year, and we examined surviving patients at the end of the five-year folloNv-up period (May 1978

We previously showed that dietary omega (ω)–3 long-chain polyunsaturated fatty acids (LCPUFAs) suppress inflammation in mice with experimental autoimmune uveitis (EAU). We have now investigated the role of antigen presenting cells (APCs) in this action of ω-3 LCPUFAs. C57BL/6 mice were fed a diet supplemented with ω-3 or ω-6 LCPUFAs for 2 weeks, after which splenocytes were isolated from the mice and cocultured with CD4 + T cells isolated from mice with EAU induced by injection of a human interphotoreceptor retinoid-binding protein peptide together with complete Freund’s adjuvant. The proliferation of and production of interferon-γ and interleukin-17 by T cells from EAU mice in vitro were attenuated in the presence of splenocytes from ω-3 LCPUFA–fed mice as compared with those from mice fed ω-6 LCPUFAs. Splenocyte fractionation by magnetic-activated cell sorting revealed that, among APCs, dendritic cells (DCs) were the target of ω-3 LCPUFAs. Adoptive transfer of DCs from mice fed ω-3 LCPUFAs attenuated disease progression in EAU mice as well as the production of pro-inflammatory cytokines by T cells isolated from these latter animals. The proliferation of T cells from control Balb/c mice was also attenuated in the presence of DCs from ω-3 LCPUFA–fed mice as compared with those from ω-6 LCPUFA–fed mice. Furthermore, T cell proliferation in such a mixed lymphocyte reaction was inhibited by prior exposure of DCs from mice fed an ω-6 LCPUFA diet to ω-3 LCPUFAs in vitro. Our results thus suggest that DCs mediate the anti-inflammatory action of dietary ω-3 LCPUFAs in EAU.